Alcoholic coma is a pathological condition that develops against the background of alcoholism. Treatment of alcohol addiction is a very difficult and long journey. Half of patients who are dependent on alcohol-containing liquids die from complications caused by excessive consumption. And the other half leaves the world due to accidents.
For a healthy person, a dose of alcohol in the amount of 300–500 ml is considered toxic, and if you drink 1600 ml, then signs of severe poisoning will begin to appear (pain in the abdomen, vomiting and faintness). A dose of more than 1800 ml leads to the development of coma (blueness of the skin, noise when breathing, decreased body temperature).
But unfortunately, the state of alcoholic coma occurs not only in alcoholics, but also in light drinkers. A person can drink a small amount of alcohol during a feast and plunge into a coma. Below, in more detail, what causes this condition, its main symptoms, first aid and treatment.
Reasons for the development of alcoholic coma
Alcoholic coma is not an independent disease, but a severe disruption of the central nervous system as a result of damage to the nerve pathways. Reception of signals by the cerebral cortex occurs through a formation stretching along the entire axis of the brainstem (reticular formation). This complex of neurons is a kind of filter in which impulses are systematized and conducted. The pathogenesis of the pathological condition is based on damage to the cells of the reticular formation and the loss of communication with the outside world by the higher part of the brain.
You can fall into a coma from drinking alcohol when the concentration of ethanol in the blood is from 0.5 to 7 ppm. This means that about 0.4 liters of pure ethyl alcohol (about two bottles of vodka) should enter the body. But in clinical practice, there have been many cases of coma from alcohol poisoning after drinking even small amounts of wine or beer. In narcology, there are several reasons for such deadly intoxication:
- chronic alcoholism with a gradual loss of control, inability to critically assess the amount of alcohol consumed;
- drinking alcohol in small quantities, but on an empty stomach;
- natural aging of the body, when the body loses the ability to absorb ethyl alcohol in the same volume.
The general state of human health also plays an important role in the development of alcoholism. For people weakened by chronic pathologies, 300 g of vodka is enough to disrupt the blood supply to the brain. The risk group includes patients with diabetes mellitus, hypo- and hyperthyroidism, and autoimmune disorders.
The effect of alcohol on the brain
Alcohol intoxication causes disruption of cellular respiration in the brain. This leads to the formation of energy deficiency with a rapid decrease in functional activity. Microcirculation is upset, and a state of hypoxia—oxygen starvation—occurs.
After ethyl poisoning, receptors are blocked, the formation of mediators is disrupted, and defective connections are formed between neurons. Almost all functions of the central nervous system are suppressed or completely lost.
Therefore, it is often impossible to revive a person in an alcoholic coma within several hours.
Hypovolemia
This is the name of the pathological condition, which is manifested by a decrease in the volume of circulating blood. In particularly severe cases, hypovolemia is accompanied by disturbances in the quantitative ratio between plasma and erythrocytes, platelets, and leukocytes. The etiology of this disorder is based on the formation of numerous and pronounced edema, including in internal organs due to the toxic effects of alcohol and its metabolites.
As a result of dehydration, oxygen and nutrient deficiency, blood pressure drops sharply to dangerous levels. In turn, complications of hypotension include a slow heartbeat and shallow breathing.
Hypoglycemia
Dehydration causes compensatory consumption of sugar to maintain normal functioning of the body. Hypoglycemia develops - a pathological condition in which the level of glucose in the systemic circulation drops below 3.5 mmol/liter. This deviation forms a special symptom complex, which is called hypoglycemic syndrome.
In post-alcohol coma, hypoglycemia is almost always observed .
Ethyl alcohol is metabolized by liver cells by the enzyme alcohol dehydrogenase. And this process is triggered by a special chemical compound that is also involved in the biosynthesis of glucose. When a large amount of alcohol enters the body, dysmetabolic syndrome develops. The enzyme is quickly consumed to break down ethanol, and there is no longer enough for the production of glucose.
Therapy of the pathological process
Treatment of alcoholic coma is carried out in a hospital setting. This is why the patient needs to be hospitalized. After the patient is admitted to the hospital, gastric lavage is performed. For this purpose, a gastric tube is used. Carrying out the procedure on your own is strictly prohibited, as the patient may experience aspiration.
For intensive therapy, a physiological five percent glucose solution is administered intravenously. In order to reduce blood acidity, patients must be administered intravenously a four percent solution of sodium bicarbonate. In order to remove water from the body, it is recommended to take diuretics. Furosemide is quite effective in this case. Patients are recommended to pre-place a catheter in order to determine how much fluid was injected and how much was removed. This procedure is carried out to eliminate brain hypoxia, which quite often causes disruption of its performance.
During the patient's therapy, the use of osmotic drugs is recommended. The most commonly used drug is Mannitol. In order to eliminate excessive formation of saliva and mucus in the lungs, patients are prescribed Atropine. This drug also helps support heart function and prevent bradycardia. If this condition does occur, then this indicates that the alcoholic coma has deepened. Caffeine is recommended to support the patient's heart function. Adsorption of toxins is carried out after taking Activated Carbon.
If patients' blood pressure drops, it is recommended to give vascular medications or hormonal medications. Since the breakdown products of alcohol are characterized by a negative effect on the human body, it is recommended that he take vitamin C, nicotinic acid, and B vitamins. In case of aspiration of vomit or problems with breathing, it is recommended to insert an endotracheal tube into the trachea. Specialists use a bronchoscope or suction to clean the pulmonary trunk and bronchi. In some cases, artificial ventilation is recommended. To avoid the appearance of an inflammatory process in the lungs, the patient must take antibiotics.
If the coma lasted no more than six hours, the patient’s health can be fully restored with adequate treatment. If the pathological condition was observed for more than 12 hours, then this significantly complicates the prognosis.
The choice of course of treatment for pathology should be made only by a doctor in accordance with the patient’s condition.
Stages of alcoholic coma
The development of alcoholic coma can occur either quickly - within a few minutes to 3 hours, or gradually - over the course of a day. In the latter case, ethanol abuse does not immediately lead to loss of consciousness and depression of central nervous system functions. Before this, the person’s condition slowly but persistently deteriorates, which makes it possible to distinguish several stages of alcoholic coma.
First degree
If a person ignores all the signs of acute alcohol intoxication, then a superficial coma develops. At the initial stage, loss of consciousness occurs, vomiting occurs, and saliva production increases. A huge amount of ethyl alcohol and its toxic metabolite acetaldehyde circulates in the blood. Alcoholic coma of 1st degree of severity is manifested by the following symptoms:
- redness of the skin, cyanosis of the nasolabial triangle;
- involuntary emptying of the bladder;
- constriction of the pupils not associated with exposure to light stimuli;
- increased respiratory rate;
- slight increase in blood pressure.
At this stage, there is a chance of self-exit from an alcoholic coma. The likelihood of this increases significantly when the blood ethanol content is less than 5 ppm.
Important information! An approaching alcoholic coma is indicated by twitching of the limbs, slurred, unrelated speech, and confusion.
Second degree
A person can remain in a second-degree alcoholic coma for about ten hours or more. During this period, ethanol is gradually metabolized, but is rather slowly evacuated from the body due to a disruption in the brain’s regulation of the liver, kidneys, and gastrointestinal tract. The following signs indicate stage 2 alcoholic coma:
- decreased skeletal muscle tone;
- slow, weak pulse;
- lack of response to any stimuli;
- spontaneous bowel and bladder emptying;
- shallow breathing.
The likelihood of waking up from a coma on your own is extremely low . If the victim is not provided with professional medical care, there is a high risk of irreversible changes in the functioning of the brain and some internal organs.
Deep alcoholic coma
A person can fall into a grade 3 alcoholic coma regardless of the amount of alcohol consumed. For example, 150-200 ml of wine is enough for a small child. Breathing slows down, pulse is intermittent, thread-like, hard to palpate. Blood pressure drops to dangerous levels, the skin is pale, moist to the touch, and cold.
Symptoms of pathology
When overdosing on alcoholic beverages, patients experience corresponding symptoms. During the first stage of the disease, the following is diagnosed:
- increased salivation;
- decreased pain sensitivity;
- relaxation of the ureteral sphincters.
When intoxicated, the heart rate increases. Blood pressure remains normal in most cases. The patient is also diagnosed with shortness of breath and wheezing.
Increased heart rate when intoxicated
The next stage of the disease is characterized by increased muscle tone in the limbs. The patient's masticatory muscles cannot fully function. This is why a person cannot talk. During this period, the patient's blood pressure increases significantly. The most common increase in heart rate is up to 100 beats per minute. A person's breathing becomes shallow.
In the following condition, disorders in the peripheral circulation are diagnosed. In some cases, the pathological process is accompanied by insufficiency in the capillary circulation. The patient's epithelium becomes bluish, and the face becomes pale. At the moment, a decrease in body temperature to 35 degrees is diagnosed. The condition is characterized by a violation of the water-salt balance. The patient may have heart failure or dehydration. The duration of an alcoholic coma directly depends on its stage.
The pathological condition is characterized by the presence of certain symptoms, by which almost any patient can identify it.
Symptoms of alcoholic coma
Symptoms of alcoholic coma vary depending on the severity of intoxication. But victims always experience loss of consciousness, drooling, bluish skin, and shallow, weak breathing. In narcology, signs of alcohol poisoning are identified that are harbingers of coma:
- dizziness, impaired coordination of movements;
- redness of the skin followed by paleness and a bluish tint;
- constriction of the pupils, weak reaction even to bright light;
- rapid breathing, feeling of lack of air when inhaling, shortness of breath;
- muscle hypertonicity, and then excessive relaxation of skeletal muscles;
- a slight increase in general body temperature followed by a decrease;
- gradual decrease in blood pressure.
A characteristic sign of an impending alcoholic coma is pain in the cardiac region. The heart has difficulty pumping blood, despite the decrease in blood volume. Gradually the pain subsides, and the person loses consciousness - a coma sets in.
Ancient folk recipes for hangovers
Alcohol poisoning is a fairly common and ancient disease. Therefore, there are many folk recipes, potions and even conspiracies that will help relieve alcohol intoxication. However, not all of them are quite effective, and sometimes even dangerous.
Let's look at a few of the most popular recipes:
- Water with honey. A drink made from 150 g of honey and an arbitrary amount of boiled water contains fructose, which reduces the symptoms of hangover and poisoning during alcohol intoxication and promotes the elimination of toxins.
- Herbal teas. Linden flowers, parsley root, mint leaves and thyme, and saffron powder are suitable for brewing.
- Egg white. To relieve alcohol intoxication at home, beat 2 fresh egg whites and drink in one gulp.
- Ammonia. Dissolve 8-10 drops in half a glass of water and drink a sip every 15 minutes.
- Citrus. Fresh orange or lemon juice saturates the body with vitamin C and stabilizes blood sugar levels.
- Brine. The old recipe has not lost its relevance. Brine, especially from sauerkraut, is rich in vitamins and salts, is easily absorbed into the blood and helps cure a hangover.
First aid for alcoholic coma
Before providing first aid for an alcoholic coma, you must call a doctor. Resuscitation measures may be required to save the victim's life. If he is in extremely poor condition or the child has been poisoned, then you need to go to meet the ambulance team.
With superficial coma
The person must be turned on his side so that the airways do not become clogged when vomit is expelled. Then you should bring cotton wool moistened with 2 drops of ammonia (ammonia solution) to your nose. If the victim regains consciousness, you need to adhere to the following algorithm of actions for an alcoholic coma:
- put the person down, calm him down, cover him with a blanket;
- induce vomiting by giving 1-2 liters of warm water;
- use any enterosorbent (Enterosgel, activated carbon) to neutralize alcohol residues;
- Offer hot sweet tea to normalize blood pressure.
The arriving doctor will examine the victim. They will be prescribed treatment at home or a decision will be made to hospitalize them.
In deep coma
Emergency care for an alcoholic coma of this type can only be provided by a doctor. Before his arrival, you should clear your mouth of vomit and control the victim’s breathing. In case of severe cramps, you need to hold your limbs so that the person does not harm himself. The doctor admits him to hospital for further treatment in a hospital setting.
Depression
The term “alcohol depression” is common among doctors. It is not included in the international classification of diseases, but a similar problem has characteristic features. Alcoholic depression is a human condition that occurs after heavy drinking or after giving up alcohol. In the first case, the syndrome goes away on its own, while alcoholic depression in those who stop drinking is very dangerous. But why?
After all, a person begins a new life, the consequences of alcoholism for his health gradually disappear. However, in their souls such people experience enormous depression, do not see the meaning of life, and neither their wife nor children make them happy. They are characterized by sudden mood swings (aggression is replaced by tearfulness), insomnia, and thoughts of suicide.
Alcohol depression is a sign that a person remains seriously psychologically dependent. If you do not consult a specialist in time, alcoholic depression can lead to suicide or breakdown. Moreover, the breakdown can be so strong that it will cause a coma. In general, alcoholism and depression are two conditions that are closely related.
We invite you to read: Scientists have proven that alcohol prolongs life
Treatment of patients in an alcoholic coma
After prehospital care is provided, medical intervention is required. Often, this is the only way to save the victim’s life even after a short-term cardiac arrest. He will be transferred from intensive care to the toxicology department for treatment. What pharmacological drugs can be used:
- injection solutions of Ringer, glucose, sodium bicarbonate, sodium chloride;
- enterosorbents;
- diuretics;
- hypertensive or antihypertensive drugs;
- oral medications to restore water and electrolyte balance.
If chronic alcoholism was identified during the diagnostic process, treatment will be offered.
Causal factors
The dosage of alcohol when an alcoholic coma manifests itself varies from the general health of the person, his age, weight and gender, the functioning of the excretory system and digestive organs. For example, 70% of men weighing more than 80 kilograms after 30 years of age experience a coma after consuming more than 450 milliliters of vodka. There are many reasons for the development of the condition.
We suggest you read: Rapid heartbeat after alcohol: causes and treatment
Risk factors taken into account:
- craniocerebral lesions;
- acceptance of low-quality products;
- taking medications.
note
Coma occurs due to the effect of alcohol on the brain, when bilateral diffuse damage to its trunk and cortex is observed, the reticular formation is activated, providing muscle toning. Hypovolemia manifests itself (a decrease in the amount of circulating blood), the volume of sugar decreases (hypoglycemia), and metabolic processes are inhibited.
Rehabilitation after an alcoholic coma
Often, timely provision of first aid helps to avoid further mental disorders. But internal organs may be damaged. After a thorough examination, a course of hepatoprotectors, stimulators of gastrointestinal and kidney regeneration is prescribed.
To replenish fluid reserves, you need to drink a lot of clean water . But it is best to use a solution of Regidron or Gidrovita, which contain the most important electrolytes.
Actions of relatives
A person who has suffered such a dangerous condition as an alcoholic coma needs a long recovery period. The patient's relatives must remember that this period will be very long and difficult, especially if we are talking about a deep coma. Throughout this entire period, the patient needs not only moral support from relatives, but also help. Some people who have emerged from a deep coma for a long time find themselves unable to perform even basic actions for self-care , which means that the task of relatives is to help the patient with this, and also to ensure that the patient takes medications on time and follows all the doctor’s instructions.
Consequences and complications of alcoholic coma
The most dangerous consequence of an alcoholic coma is death. In the absence of medical intervention, death occurs in the vast majority of cases. Its immediate causes are the retraction of the tongue and the entry of vomit into the respiratory tract. Stopping breathing and work occurs as a result of severe dysfunction of the central nervous system.
Sometimes the brain is no longer able to fully regulate the functioning of all vital systems of the body. This can lead to the development of various diseases of the internal organs. There have been cases of significant deterioration in mental activity.
Diagnostic measures
In the first hours of an alcoholic coma, immediate action is required; there is no time for instrumental diagnostics. The doctor takes measures to select emergency measures, based on the data from the external examination of the patient. A blood test is carried out after surgical detoxification (this is regulated by Order of the Ministry of Health No. 40 “On the organization of chemical and toxicological studies in the presence of alcohol and toxic substances in the body”).
Detailed chemical and toxicological tests, CT scan of the brain, and chest X-ray are performed when the patient cannot be brought out of a superficial coma and a complex or deep stage of coma occurs. Be sure to determine the CBS, the level of sodium, potassium, calcium, chlorides in the blood serum, and also carry out ALAT and ASAT tests. Additional is the determination of the level of myoglobin, creatine kinase (if a brain or spinal cord injury is suspected), a clinical analysis of the cerebrospinal fluid, and the detection of ketone bodies. These are differential diagnostic measures that allow us to screen out or confirm non-alcoholic causes of central nervous system depression.
Prevention
The best preventive measure is to stop drinking alcohol. The development of alcoholic coma is caused by:
- combining alcohol with pharmacological drugs, for example, antipsychotics, tranquilizers;
- combination of alcohol with narcotic substances - psychostimulants, hallucinogens;
- criminal negligence of parents leaving alcohol in places accessible to children and health.
It is necessary to exclude such situations and try not to keep alcoholic beverages in the house. If a family member is addicted, they should be persuaded to undergo treatment.
Recovery period
After a coma lasting no more than 6 hours, the patient has a chance to restore health, provided, of course, he refuses to drink alcohol in the future.
If the alcoholic coma lasted more than 12 hours, the prognosis is difficult. The patient should pay special attention to restoring the functions of the circulatory system and heart.
He needs to take vitamin complexes with minerals, restore the water-salt balance disturbed by dehydration. Drugs are required to improve liver function, blood circulation, and brain function.
You can only cope with the destructive effects of alcohol caused by coma by turning to professionals who can provide a full range of specialized medical care.
